Organ Trafficking

The various forms of human trafficking are commonly distinguished by their purpose: for sexual exploitation, for labour exploitation, and for exploitation of the bodily organs of the victim. While there is significant research and political focus on the first two forms of human trafficking, the latter, organ trafficking, receives relatively less attention. In Canada, organ trafficking mainly occurs through a phenomenon called “transplant tourism”, in which Canadians visit another country to receive an organ transplant in a foreign hospital. Organ trafficking is the most transnational form of human trafficking, as both sex trafficking and labour trafficking typically operate intranationally.Currently, data from the World Health Organization (WHO) shows that of the 106,879 solid organs known to have been transplanted in 95 member states in 2010 (legally and illegally), about 73,179 (68.5%) were kidneys. But those 106,879 operations satisfied just 10% of the global need, therefore illuminating the very shortage of organs that fuels the organ trafficking phenomenon. An estimated 10,000 black-market operations involving purchased human organs occur annually – more than one every hour – according to WHO. It estimates that organ trafficking accounts for five to 10 per cent of all kidney transplants worldwide. There are currently several international standards in place for combating the trafficking of organs, including the United Nations Protocol to Prevent, Suppress, and Punish Trafficking in Persons, the Optional Protocol on the sale of children, child prostitution and child pornography to the UN Convention on the Rights of the Child, and the World Health Organization’s Guiding Principles on Human Organ Transplantation, among others. CanadaCanada is among the top ten of global importer of organs. The most common organs sought for in the 'organ market' are kidneys, followed by livers, for purposes of transplantation. According to the UN, such practices have increased exponentially in recent decades with the growing demand for live-donor organ transplants. This demand is attributable to an increasing differential between rates of end-stage renal disease (ESRD) and deceased donor organ donation. To contextualize, there are more than 3,300 Canadians on waiting lists for a kidney transplant — almost double the number 20 years ago — and close to a third of them are from Ontario, according to the Canadian Institute for Health Information. More than 300 people from Ontario on those lists have died in the past decade. These statistics illustrate the desperation that entices many Canadian patients to turn to transplant tourism.Transplant TourismTransplant tourism is a very complex phenomenon. PACT-Ottawa wants to emphasize that not all transplant tourism is necessarily organ trafficking. Transplant tourism is not framed as organ trafficking when the donor has not been forced or deceived into donating the organ, when all medical and other procedures (such as an appropriate payment and proper medical aftercare) have been followed, and if the donor has truly consented to donating an organ.·According to the Declaration of Istanbul all commodification of organs is ethically wrong, and must be criminalized.·However, Ric Esther-Bienstock makes a strong argument that transplant tourism can empower local donors in harsh socioeconomic positions too.·Furthermore, transplant tourism can be seen as a health hazard to Canadian citizens, as the care in other countries may be suboptimal.·The profit margins of the middle men and involved hospitals may be huge, which would provide a strong incentive towards organ trafficking.·There is a significant shortage of organs within Canada, which would provide a strong incentive for Canadians to get their often lifesaving organs elsewhere.Developing a Policy Framework to Combat Organ TraffickingPACT-Ottawa is involved in the effort to combat organ trafficking as stories of atrocities while extracting organs from involuntary donors have continuously haunted the international press, and have been acknowledged by the United Nations, World Health Organization, and the Canadian government. These confirmed stories could be extreme examples of organ trafficking and warrant action.“This form of trafficking in persons follows patterns similar to other forms of human trafficking (e.g. exploitation of vulnerable populations), but intrinsically contains significant differences. Some of the actors and modus operandi of this crime stand in sharp contrast to other forms of trafficking in persons, e.g. the requirement of medical professionals, the matching of an organ recipient, the duration of exploitation and the subsequent release of the victim. Knowledge of these practices is not well known and, resultantly, the response globally has been, at best, uneven.” Indeed, in Canada no quantitative data are collected, even though this would be possible due to the necessary aftercare in hospitals of the Canadian transplant tourists after receiving a transplant. Because no data is available, it is impossible to say how many Canadians partake in transplant tourism, how often and from where the organs are acquired through organ trafficking.Apart from a complete lack of monitoring and an ambiguous legal status, the only existing policy effort geared towards transplant tourism is a joint endeavor by the Canadian Society of Transplantation and Canadian Society of Nephrology. This policy paper contains advice for doctors as to how they should warn potential transplant tourists for the ethical dangers involved, and how to treat homecoming Canadians after their transplant in another country.The lack of action constitutes a problem of responsibility. PACT-Ottawa is of the opinion that Canada should take responsibility for this issue, as it is one that is multi-layered and involves the exploitation of countless individuals. Canada has the resources and is in the position to take responsibility in curbing this phenomenon.Canadian Conference on Organ TraffickingIn response to this growing issue, PACT-Ottawa is organizing a conference with the aim of implementing a policy regarding transplant tourism. Due to the complex nature of this phenomenon, PACT-Ottawa does not have all the expertise necessary. The conference will be organized in such a way that participating experts, organizations and institutions have the opportunity to share their expertise and influence the agenda. Together, we must take action in order to develop a framework that tackles the issue of organ trafficking.

Additional Resources

Please consider browsing the articles and other material related to organ trafficking curated by a PACT-Ottawa volunteer here.